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11D2060242 CLIA NUMBER - VILLAGE PEDIATRICS, PC

Laboratory Demographics

CLIA Number: 11D2060242

Facility Name: VILLAGE PEDIATRICS, PC

Facility Address:
1862 AUBURN ROAD, SUITE 107
DACULA, GA
ZIP 30019
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Facility Phone Number: 678 288-4142

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1598101388

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 11D2060242
LAB Type Physician Office
Facility Name VILLAGE PEDIATRICS, PC
Street 1862 AUBURN ROAD, SUITE 107
City DACULA
State GA
ZIP 30019
Phone 678 288-4142
CertificateType 4
CertificateEffectiveDate 6/10/2023
CertificateExpirationDate 6/9/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024